Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 097625 | NY |
NPI | 1528311651 |
---|---|
Provider Name | Dr. Arsenio B Vivera |
First Address | New York, NY 10017-1500 |
Second Address | New York, NY 10017-1500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2012 |
Last Update Date | 26/10/2012 |